- Hi there, welcome back to the channel. If it's the first time
that you're joining us, I'm Dr. Sylvia, a general practitioner and the founder of AskAwayHealth where we provide you with
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a week on Saturdays, you're one of the first to know about it. ♪ Hey now ♪ ♪ Take a step outside
and seize the day now ♪ ♪ Set aside your worries ♪ ♪ It's okay now ♪ ♪ The sun is here to stay ♪ - Today we're talking about
emergency contraceptive pills but let's start with what's
emergency contraception? So the emergency contraceptive pill is a medicine that's taken by mouth that's not a
regular contraceptive method. So it's used as an ad-hoc measure, for example, if somebody has
been on regular contraceptives and they forgot to take their pills or if they've had an
unplanned sexual encounter or perhaps they have been using condoms during a sexual encounter but the condom splits. Now, the most common forms
of emergency contraception are the condoms, used
before sexual intercourse or the contraceptive pills, while the most effective
emergency contraceptive method is the copper IUD intrauterine device, which if used or inserted in the womb, up to five days following intercourse or five days after
ovulation has been found to be very effective in
preventing pregnancy. Right, to address the topic of this video, the first thing we need to consider is how do emergency
contraceptive pills work? But before we do that, I would like us to look
at some statements, which I refer to as reproduction
and contraception facts but which bear a lot, they're very important in regards to what we're going to be talking about in this video today. So the first fact is ovulation. Ovulation is the release of a mature egg from one of the woman's ovaries. In a woman with a regular 28-day cycle, this occurs 14 days, roughly
14 days after the first day of her last menstrual period or 14 days before the
beginning of the next period. Fact number two, normally, the egg that's been released
will survive for between 12 to 24 hours. Fact number three, sperm that is released
during sexual intercourse can survive within the woman's body for between five to seven days. Fact number four, women taking the emergency
contraceptive pill to prevent pregnancy need to know that the risk of pregnancy depends on the timing of sexual
intercourse relative to your ovulation in that
particular month's cycle and I'm going to explain more
about why this is important. Currently, the emergency
contraceptive pills that we have are in two
different categories. The one that contains levonorgestrel and commonly sold as Levonelle, Postinor, Post Pill, Postinor 2. The other category of
emergency contraceptive pill is called ullipristal acetate, which works on receptors
receptive to progesterone and it's commonly sold as Ella One. So both of these work
by delaying ovulation. That is the release of
the egg, of a mature egg from the woman's ovary by about five days. So the implications of this are taking the pill will delay the release of your egg, that is
ovulation for five days, which is roughly the same period of time for which the sperm are alive or viable. Remember, we said that sperm
released into the woman's body can last between, remain viable or remain alive for
between five to seven days. The second implication,
if you think about it, is the emergency contraceptive pills are only effective when
used before you ovulate. So if you take them and you have already ovulated, then they're not going to work. They're not meant to work that way. So it's really important and that's why we said that women need to be aware that the risk of pregnancy when they are taking the
emergency contraceptive pill is related to the time
that they have intercourse and how it's related to have you ovulated or have you not ovulated, which bit of your cycle, your
menstrual cycle are you in? So it naturally goes on to mean that taking the emergency
contraceptive pill in the part of your
cycle before you ovulate is when it's most effective. Now, we know that levonorgestrel, the emergency contraceptive pill is most effective when it's taken from straightaway after intercourse from up to 72 hours after intercourse but all this is as long as
it within the first part of your cycle before ovulation. Now, ulipristal, the other
emergency contraceptive pill, also delays ovulation but up to five days
until the sperm produced during that episode of sexual intercourse for which the pill was
taken have died away. So that's its way of working, of preventing pregnancy. So this is also important because we said that levonorgestrel is effective up to 72 hours. It is most effective on the first day or immediately taken
after sexual intercourse. It carries on being effective but that effectiveness is reducing, so the effectiveness rate is reducing up to the third day. Now, for ulipristal, it's effective as soon as you take it following sexual intercourse but it stays on that level for up to five days after unprotected sexual intercourse. So that's another way that it is more effective
than levonorgestrel. So this is the first reason, obviously we're doing this video because we're trying to work out why somebody has used the
emergency contraceptive pill but oh no, three weeks
later, she's pregnant. This is the first reason for why you think the pill hasn't worked. Actually, it can't work
if you take it in the half of your cycle when you have ovulated. So a woman's cycle can be split in half by the process of ovulation. So the half before ovulation and the half afterwards. And what I'm saying is that the emergency
contraceptive pills work by delaying ovulation and so they will not work
if you have intercourse in that part of your
cycle after ovulation. They're not going to work. So that's the first reason. So let's look at the second reason. So let's say that everything lines up. Sexual activity has happened during the period before ovulation and the woman has taken the
emergency contraceptive pill. Fantastic. But what happens if she
still falls pregnant? What could have happened? So this is something else to remember and which we also need to make sure that every woman who's
taking the pill is aware of. Remember that we said the
emergency pill delays ovulation. Fine, so for five days
the egg is kept on hold and after the fifth day, the egg is released. What happens if she has
sexual intercourse again and hasn't got any
protection at that point? That egg that we delayed for five days is going to meet viable sperm from the next episode
of sexual intercourse and she could get pregnant
as a result of that. So the message, of course,
is that you would need to use another pill or another method of
emergency contraceptive if sexual intercourse happens again after the egg has been released. So these are the main reasons for why the emergency
contraceptive pill might appear to have failed. It's about timing and yeah, pretty much about timing and just being aware that you need to protect yourself at
certain times of the month with the right method and being aware that engaging in unprotected sexual intercourse, even after you've used the pill does not mean that you
are necessarily covered by that same method. So it's something that
bears thinking about. And as I mentioned at the beginning, by far, the most effective form of emergency contraception is the copper intrauterine device, the copper IUD. This works by preventing fertilization and implantation and the copper IUD can be effective if
inserted up to five days, following sexual intercourse and up to five days following ovulation for a woman who has a regular period and whose menstrual cycle is known so we can calculate the dates. So I have one question that I'd love to ask you guys and I'd love to hear
from you in the comments. So how often do you think it's appropriate to use the emergency contraceptive pill? How often do you think is right? Why do you think so? And is twice or thrice
a month just too much? What do you think? Share your thoughts in the comments. And that brings me to
the end of this video. Thank you so much for watching. If you've got any questions on this particular
topic, send us an email. I'll put the details in
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listening to this one, guys and I will see you again soon.
